How iPatientCare stood up to Physician Burnout!!!

Recently, I came across an article about Physician Burnout in one of the HealthCare websites, specified majorly on the amount of stress, a Physician goes through just in a day. It isn’t about ‘not’ going out for an annual Vacation or about ‘not’ going out for a Movie over weekends; but in this busy schedule, there are times when Physicians even forget to have their Breakfast, Lunch or Dinner; there have been weeks that they don’t get to see their families. Read more ›

Posted in EHR, Revenue Cycle Management

MIPS Participation: To Group or Not to Group – That is the Question

MIPS (Merit-based Incentive Payment) is one of the pathway under MACRA Quality Payment Program  which streamlines multiple quality reporting programs and provides payment adjustments to eligible clinicians based on their performance. Under MIPS, you can report as an Individual or a Group. Before you decide to go for Group or Individual, it is important to understand the implications of both. I have already explained in my previous blog how the MIPS eligibility is determined at the Individual level and Group level and its impact on the payment adjustments. Read more ›

Posted in MACRA Tagged with: , ,

Managing Denial: Proven techniques that get claims paid

The best defense is a good offense” a precept that has been applied in various fields. You have to be attentive when filing claims to insurance to achieve the max first pass acceptance ratio. Your perception that everything was submitted correctly, still leads to scores of reasons for claims to get denied by the insurance. Lack of specificity of codes being used, modifiers not been applied correctly and many more such reasons which might show less in percentage but would out way the overall charges submitted. The American Medical Association reports that between 1.38 percent and 5.07 percent of claims are denied by insurers. Even the best-performing medical practices experience a denial rate of 5 percent, reveals the Medical Group Management Association. Read more ›

Posted in Revenue Cycle Management Tagged with:

$400 Billion wasted due to RCM inefficiency

Infographic

Due to Medical Billing errors, hundreds of dollars are lost.  The infographics below shows the Technology Enabled Services provided by iPatientCare to assist in improving financial performance so as to receive well deserved long term benefits. Read more ›

Posted in Revenue Cycle Management Tagged with:

MIPS Participation- Part-2 – What I need to do now?

Review the letter to know the eligibility status of your group and each individual NPI within your TIN.

If I am included in MIPS: You must participate by submitting your performance data by 31st March 2018 to avoid negative payment adjustment and can even earn a positive adjustment. You can pick your pace – whether you want to submit full year data from 1st January 2017 to 31st December 2017, submit data for 90 days period starting anytime between 1st January 2017 and 2nd October 2017, or submit data for one of the performance categories. Read more ›

Posted in MACRA Tagged with: , ,

MIPS Participation- Part-1 – Decoding Eligibility Criteria

CMS has come up with a tool (https://qpp.cms.gov/learn/eligibility) to check your MIPS eligibility status. They are also sending out letters to clinicians informing them about the MIPS Participation Status. What is this all about? Read more ›

Posted in MACRA Tagged with: , ,

Estimating your Revenues under MIPS

With MIPS replacing the PQRS and EHR Meaningful Use Incentives, what healthcare providers want to know is “How is my today’s performance going to affect my cash flow beginning 2019?” Unlike PQRS and EHR incentive program, MIPS does not award fixed positive or negative payment adjustments – the adjustments vary from provider to provider based on their performance. It is, therefore, crucial to familiarize with the new payment model and its financial implication on your practice. Read more ›

Posted in MACRA, Quality Improvement Consulting Tagged with: ,

MACRA Simplifications for Small Practices

MACRA is finally here and Clinicians are overwhelmed by the changes and complexities in the New Payment Model. CMS has been working with GAO (Government Accountability Office) to understand the unique needs and challenges faced by clinicians in small practices and practices serving the rural or health professional shortage areas. Using the knowledge obtained from GAOs and the feedback from small practices, other stakeholders and public, CMS has come up with various flexibility options and support to ease their burden. CMS defines small practices as those having less than 15 Eligible Clinicians. Read more ›

Posted in MACRA Tagged with: ,

The Deadly Consequences: Forgiving Patient’s Responsibility

Sometime back prior to 1940s, most of the people in the United States paid their own medical bills. It was a “Direct Pay” where people were treated and cared for in their homes and were expected to pay for that care and treatment. Healthcare practitioners in certain cases would give essential treatment, at no charge for those individuals who could not afford to pay for services rendered. Read more ›

Posted in ICD-10, Practice Management solutions, Revenue Cycle Management Tagged with: , , ,

Estimate Patient Expected Out-of-Pocket Responsibility

It’s nearly 75% of provider organizations bad debt are reported from outstanding patient balances. Thanks to the Affordable Care Act plans, high deductible and larger co-pay’s continues to soar patient financial responsibilities.

Ground Reality: A larger portion of patient’s walks out of the provider’s office without paying a dime. This trend is soaring on the higher side because of inability to determine what you can collect. Co-payments are a given sure shot, but will your payer contracts allow you to capture coinsurance and unmet deductibles? Read more ›

Posted in Practice Management solutions Tagged with: , ,

MIPS Financial Calculator